Immunohistochemistry (IHC) is often used to diagnose suspect biological material. In addition, IHC techniques can be used prognostically to assist clinical decision makers. Typically, a source of biological material such as tissue is sent to a dedicated laboratory which then undergoes histological processing. Histology processing includes, for example, processing of tissue samples to fix and preserve the tissue samples. Fixing the tissue samples prevents degradation and stops the cells from changing characteristics. After fixation, tissue samples are then stained with one or more stains. The stained samples are contained on slides which can then be imaged for subsequent viewing.
Certain stains enable the pathologist to see the cellular structure and morphology under a microscope more easily. Still other stains or markers are antigen-specific and preferentially bind or otherwise associate with diseased tissue (e.g., cancerous tissue). These antigen-specific stains or markers can be used by a pathologist (or other trained professional) to score a particular slide.
For example, under prior testing processes, a client would send a tissue specimen and test request to a dedicated laboratory. The laboratory would then stain the slides with the appropriate IHC markers and, when ordered, provide a quantitative analysis of the sample using a computer that was directly associated with or otherwise locally connected to an imaging device such as a scanner. The images and any analysis are generated on a report using the computer associated with or locally connected to the imaging device. The images are then burned to a portable storage medium such as, for example, a DVD and sent back to the client with the original slides. The client can view the images and is given the option to supplement or alter the report using their professional interpretation.
There are several disadvantages, however, with a system and method like the one described above. First, because the images are stored on a DVD (or the like) and sent back to the client, there is a significant delay in the amount of time it takes for a pathologist or other trained health professional to review the slide. This delay can amount to several days. This delay can be troubling from a psychological perspective of the patient (e.g., waiting for the results of a breast biopsy for possible cancer). In addition, if diagnosis can be made soon after a sample is prepared and imaged, the patient can be treated that much sooner. In the case of cancer diagnosis, the patient can immediately start undergoing chemotherapy—a potentially life saving advantage over current methods. In addition to the delay, there is an increased cost of delivering the image-files via the mail or by way of courier.
The current method of delivering digital images to pathologists on DVDs (or other portable media) also restricts the ability to get multiple opinions from professionals located in different geographic locations. For example, using current practices, the same DVD would have to be forwarded to different pathologists in order to obtain multiple opinions (or multiple DVDs sent out simultaneously). This cumbersome and time-consuming procedure prevents patient's from obtaining multiple opinions on a timely basis.
Another disadvantage of the current system and method is that additional stains are often employed on a sample based on the initial results or scoring of a slide. For example, a physician may order a screening test for cancer which employs a broad-based or general stain. If this test is positive for cancer, the physician may follow-up with one or more additional tests using other stains which are more specific (e.g., stains which may identify whether a particular cancer is highly metastatic). Using the current system, several days (or more) are lost in sending the initial slide images to the pathologist. It would be preferable if the slide images were available almost immediately after imaging. In this manner, subsequent staining and imaging of the sample may be accomplished without delay.
There thus is a need for system and method in which pathologists or other trained health care professionals have virtually immediate access to imaged slides. Such a system and method would decrease the amount of time necessary to diagnose a particular condition or diseased state. In addition, multiple opinions could be obtained without the need to deliver images stored on a portable storage medium. The system and method would preferably permit a physician or other health care professional to order additional staining tests on a timely basis. Finally, the system and method would permit pathologists or other trained health care professionals to view and score slides from virtually any geographic location.